| NPI | 1265251094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLY MELISSA MOCK Licensed Professional Counselor 912-618-9568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2024-10-08 |